Healthcare Provider Details
I. General information
NPI: 1205724077
Provider Name (Legal Business Name): AHCS PUGET SOUND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3855 MARTIN WAY E # A
OLYMPIA WA
98506-5268
US
IV. Provider business mailing address
PO BOX 3055
HUNTINGTON BEACH CA
92605-3055
US
V. Phone/Fax
- Phone: 360-810-3710
- Fax: 360-810-3711
- Phone: 714-706-9030
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
ZEGLINSKI
Title or Position: CEO
Credential:
Phone: 714-706-9030